Methods of diagnosing increased risk of developing mrsa

ABSTRACT

A method for diagnosing increased risk of developing Methicillin-resistant  Staphylococcus aureus  (MRSA) hospital-acquired (HA-MRSA) or community-acquired MRSA (CA-MRSA) which includes obtaining a biological sample from a subject, detecting in the sample a single nucleotide polymorphism (SNP) in the FAM129B gene at position 17 of SEQ ID NO 1, and comparing the nucleotide at position 17 of SEQ ID NO. 1 in the sample with the nucleotide at position 17 in SEQ ID NO. 1, wherein an adenine at position 17 of SEQ ID NO. 1 in the sample indicates an increased risk of developing MRSA or CA-MRSA in the subject.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims priority from U.S. Provisional Application No. 61/779,307, filed Mar. 13, 2013, the entire contents of which are incorporated by reference.

SEQUENCE LISTING

This application incorporates in its entirety the Sequence Listing entitled “2014-03-10_5475-353958_056-US_SEQ_LISTING_ST25.txt” (96,447 bytes), which was created on Mar. 10, 2014, and filed electronically herewith.

BACKGROUND OF THE INVENTION

Staphylococcus aureus (staph) bacteria are a common component of the skin surface and lining of the nasal passageways in humans and other animals, and are usually spread by skin-to-skin contact. Methicillin-resistant S. aureus (MRSA) is a strain of S. aureus that has become resistant to methicillin, an antibiotic commonly used to treat ordinary S. aureus infections. As such, MRSA is particularly hard to treat. When limited to the skin surface and lining of the nasal passageways, S. aureus bacteria are normally harmless. However, S. aureus infections can occur in situations where the bacteria enter into the skin subsurface or body cavity, normally through wounds (including, e.g., surgical incisions) or other sites such as hair follicles.

MRSA infections often occur in patients having weakened immune systems who have been exposed to MRSA, such as patients in long term care, patients undergoing kidney dialysis, or patients recovering from recent surgery or medical treatments such as chemotherapy that weaken the immune system. Skin wounding events or other forms of compromise to skin integrity (e.g., intravenous drug use) are another major risk for MRSA infection, which risk may or may not coincide with the exposure risk. MRSA is often acquired or develops in medical care facilities, such as hospitals. This type of MRSA is known as health care-associated MRSA (HA-MRSA). But MRSA can also develop in otherwise healthy people not exposed to hospital situations. In these situations, it is termed community-acquired MRSA (CA-MRSA). CA-MRSA has often been found to be acquired by athletes (who may share towels and razors), children in day care, members of the military and people obtaining tattoos, for example.

Symptoms of staph infections may include red, swollen and painful boil-like symptoms, which may be treated locally. In severe cases and in hospital situations, staph infections may be systemic and must be treated with systemically administered antibiotics.

Some individuals seem to be uniquely susceptible to staph infections and developing recurrent CA-MRSA skin infections. Such populations may also have an elevated risk for developing MRSA if admitted to medical care facilities. Treatment for these individuals involves attempts to decolonize the skin and nasal passages of the patient with topical antibiotics, which can be temporarily effective, especially when coupled with improved sanitation such as frequent hand washing and isolation from other patients. Thus, improved methods of recognizing persons susceptible to recurrent MRSA and/or CA-MRSA are needed and can improve patient care and reduce the incidence of MRSA in these individuals.

SUMMARY OF THE INVENTION

We describe methods of predicting or assessing the level of risk of a subject developing a Methicillin-resistant S. aureus (MRSA) infection comprising: obtaining a biological sample from the subject, wherein said biological sample includes at least one oligonucleotide occupying a locus corresponding to position 17 of SEQ ID. NO 1; detecting the identity of at least one oligonucleotide occupying the locus corresponding to position 17 of SEQ ID. NO 1; determining whether at least one oligonucleotide occupying the locus corresponding to position 17 of SEQ ID. NO 1 is an adenine or a cytosine; and predicting and assessing the level of risk of the subject developing a MRSA, wherein an adenine occupying the locus corresponding to position 17 of SEQ ID. NO 1 indicates that the subject has a high risk of developing a MRSA infection and a cytosine occupying the locus corresponding to position 17 of SEQ ID. NO 1, indicates that the subject has a low risk of developing a MRSA infection.

We describe embodiments wherein the detecting step further comprises hybridizing at least one oligonucleotide occupying a locus corresponding to position 17 of either SEQ ID. NO: 1, to an oligonucleotide probe comprising a sequence that is complementary or identical to SEQ ID NO. 1, under stringency conditions than can detect the presence of different alleles at position 17 of said oligonucleotide or hybridizing at least one oligonucleotide occupying a locus corresponding to position 17 of SEQ ID. NO: 2, to an oligonucleotide probe comprising a sequence that is complementary or identical to SEQ ID NO: 2, under stringency conditions that can detect the presence of different alleles at position 17 of said oligonucleotide.

We describe embodiments wherein the detecting step further comprises evaluating the hybridization of at least one oligonucleotide from the biological sample which corresponds to position 17 of SEQ ID. NO 1. and wherein the detecting step further comprises sequencing the oligonucleotide from the biological sample.

In other embodiments the detecting step further comprises amplifying the oligonucleotide from the biological sample. In some embodiments the amplifying step uses at least one oligonucleotide primer and at least one oligonucleotide from the biological sample occupying a locus corresponding to position 17 of SEQ. ID. NO. 1. The oligonucleotide primer may be comprised of DNA.

We describe methods to detect, identify and treat MRSA in all it various stages and forms including treatments make after it is determined whether the patient has a high or low risk of developing a MRSA, CA-MRSA infection or HA-MRSA and it is determined that the patient has a high risk of developing a MRSA infection, the patient is given anti MRSA antibiotics, and may also be given decolonization treatments. Once it is determined that the patient has a high risk of developing a MRSA infection, the patient may be given more than one course of anti MRSA antibiotics, decolonization treatments and may be put on high infection alert for any future surgeries.

In other embodiments after it is determined that the patient has a low risk of developing a MRSA infection, the patient is not given any antibiotics and is only treated with incision and drainage, sometimes such a low risk patient is treated with incision and drainage and given a routine antibiotic treatment that does not include anti MRSA antibiotics.

This application also describes and claims one or more primers or probes to be used to amplify or detect at least one or more nucleotides from a biological sample, wherein one or more nucleotides occupy a locus corresponding to position 17 of SEQ. ID. NO. 1. There may be one or more primers that spans the nucleotide positions about position 17 of SEQ. ID. NO. 1. The primers may be from about 8 to about 44 nucleotides in length, or from about 14 to about 50 nucleotides in length. Described are probes wherein said one or more probes span the nucleotide positions about position 17 of SEQ. ID. NO. 1. Described are probes having a different disruption energy for one allele as compared to another allele; two probes, wherein the first probe is a sensor probe and the second probe is an anchor probe; and a SNP-specific probe, in addition to methods to make and use these and other primers and probes.

In some embodiments one or more primers or probes are in a kit designed for use by a caregiver who seeks to predict or assess the level of risk of a subject developing Methicillin-resistant S. aureus (MRSA) infection, the kit and its instructions comprise obtaining a biological sample from the subject, wherein said biological sample includes at least one oligonucleotide occupying a locus corresponding to position 17 of SEQ ID. NO 1; detecting the identity of said at least one oligonucleotide occupying the locus corresponding to position 17 of SEQ ID. NO 1; determining whether said at least one oligonucleotide occupying the locus corresponding to position 17 of SEQ ID. NO 1 is an adenine or a cytosine; and predicting and assessing the level of risk of the subject developing a MRSA infection, wherein an adenine occupying the locus corresponding to position 17 of SEQ ID. NO 1 indicates that the subject has a high risk of developing a MRSA infection and a cytosine occupying the locus corresponding to position 17 of SEQ ID. NO 1 indicates that the subject has a low risk of developing a MRSA infection.

Disclosed are methods to monitor and prepare a patient for surgery, wherein said monitoring and preparing comprising obtaining a biological sample from the patient, wherein said biological sample includes at least one oligonucleotide occupying a locus corresponding to position 17 of SEQ ID. NO 1; detecting the identity of the at least one oligonucleotide occupying the locus corresponding to position 17 of SEQ ID. NO 1; determining whether said at least one oligonucleotide occupying the locus corresponding to position 17 of SEQ ID. NO 1 is an adenine or a cytosine; predicting and assessing the level of risk of the patient developing a MRSA infection, wherein an adenine occupying the locus corresponding to position 17 of SEQ ID. NO 1 indicates that the patient has a high risk of developing a MRSA or CA-MRSA infection and a cytosine occupying the locus corresponding to position 17 of SEQ ID. NO 1 indicates that the patient has a low risk of developing a MRSA or CA-MRSA infection; and wherein the predication and assessment indicates that the patient is at high risk for a MRSA infection, taking appropriate steps and care as one normally skilled in the art would take when operating on a person at high risk of developing a MRSA infection.

One aspect of the inventive method of determining whether a subject is at increased risk of developing MRSA and/or CA-MRSA, or a recurrence of MRSA or CA-MRSA, may include: obtaining a biological sample from the subject, wherein said biological sample contains at least one oligonucleotide comprising a loci corresponding to position 17 of SEQ ID. NO 1; detecting the identity of each nucleotide that occurs at a loci corresponding to position 17 of comparison SEQ ID. NO 1 in said at least one oligonucleotide; and comparing the identity of each nucleotide that occurs at a loci corresponding to position 17 of comparison SEQ ID. NO 1 in said at least one oligonucleotide to the identity of the nucleotide at position 17 of SEQ ID. NO 1, wherein the subject is at increased risk of developing MRSA and/or CA-MRSA, or a recurrence of MRSA or CA-MRSA if one or more nucleotides at the loci corresponding to position 17 of SEQ ID. NO 1 is the same as the identity of the nucleotide at position 17 of SEQ ID NO 1.

Another aspect of the inventive method of determining whether a subject is at increased risk of developing MRSA and/or CA-MRSA, or a recurrence of MRSA or CA-MRSA, may include: obtaining a biological sample from the subject, wherein said biological sample contains at least one oligonucleotide comprising a loci corresponding to position 17 of SEQ ID. NO 2; detecting the identity of each nucleotide that occurs at a loci corresponding to position 17 of comparison SEQ ID. NO 2 in said at least one oligonucleotide; and comparing the identity of each nucleotide that occurs at a loci corresponding to position 17 of comparison SEQ ID. NO 2 in said at least one oligonucleotide to the identity of the nucleotide at position 17 of SEQ ID. NO 2, wherein the subject is not at increased risk of developing MRSA and/or CA-MRSA, or a recurrence of MRSA or CA-MRSA if the one or more nucleotides at the loci corresponding to position 17 of SEQ ID. NO 2 in said at least one oligonucleotide is the same as the identity of the nucleotide at position 17 of SEQ ID NO 2.

In other aspects, the detecting step may further comprise hybridization of said at least one oligonucleotide comprising a loci corresponding to position 17 of SEQ ID NO. 1 to a probe comprising an oligonucleotide comprising a sequence complementary or identical to SEQ ID NO: 1, under stringency conditions than can detect the presence of different alleles at position 17 of said oligonucleotide. In other aspects, the detecting step may further comprise hybridization of said at least one oligonucleotide comprising a loci corresponding to position 17 of SEQ ID NO. 2 to a probe comprising an oligonucleotide comprising a sequence complementary or identical to SEQ ID NO. 2, under stringency conditions than can detect the presence of different alleles at position 17 of said oligonucleotide. In other aspects, the detecting step further comprises evaluating the hybridization of an oligonucleotide containing a locus corresponding to position 17 of comparison SEQ ID NO: 1 or 2 derived from said subject to a probe comprising a sequence complementary or identical to SEQ ID NO: 1 or 2, under stringency conditions that can determine the presence of different alleles at position 17 of said oligonucleotide.

In other aspects, the detecting step may further comprise amplifying at least one oligonucleotide from said biological sample containing a locus corresponding to position 17 of comparison SEQ ID. NO 1, wherein said amplifying step uses at least one oligonucleotide primer. In other aspects, the detecting step further comprises amplifying at least one oligonucleotide from said biological sample containing a locus corresponding to position 17 of comparison SEQ ID. NO 2, wherein said amplifying step uses at least one oligonucleotide primer. In some aspects, the oligonucleotide primer comprises DNA.

In other aspects, the determining step may further comprise using a probe to detect the presence of a locus corresponding to position 17 of comparison SEQ ID. NO 1 in the biological sample. In other aspects, the determining step may further comprise using a probe to detect the presence of a locus corresponding to position 17 of comparison SEQ ID. NO 2 in the biological sample.

In other aspects, the probe may be labeled with a detection signal. In other aspects, the probe may comprise an oligonucleotide having a sequence that is complementary or identical to a region flanking the locus corresponding to position 17 of comparison SEQ ID. NO 1 and/or 2, or the probe may be complementary or identical to SEQ ID NO 1 and/or 2.

In other aspects, the method may further comprise treating the subject with an antibiotic effective against MRSA, when the subject is found to be at increased risk of developing MRSA, CA-MRSA or having a recurrence of MRSA or CA-MRSA. In other aspects, the method may further comprise treating the subject to remove or prevent colonization by skin-surface or intranasal populations of MRSA, when the subject is found to be at increased risk of developing MRSA, CA-MRSA or having a recurrence of MRSA or CA-MRSA.

Embodiments of the present invention may comprise a kit for determining whether a subject is at increased risk of developing MRSA, CA-MRSA, or a recurrence of MRSA and/or CA-MRSA, comprising at least one primer for amplification of one or more nucleotides that occur at a loci corresponding to position 17 of comparison SEQ ID. NOS. 1, 2 or a combination thereof from a biological sample from the subject.

Other embodiments of the present invention may comprise a kit for determining whether a subject is at increased risk of developing MRSA, CA-MRSA, or a recurrence of MRSA and/or CA-MRSA, comprising at least one probe for detection of one or more nucleotides that occur at a loci corresponding to position 17 of comparison SEQ ID. NOS. 1, 2 or a combination thereof from a biological sample from the subject.

DETAILED DESCRIPTION

Before the subject invention is described further, it is to be understood that the invention is not limited to the particular embodiments of the invention described below, as variations of the particular embodiments may be made and still fall within the scope of the appended claims. It is also to be understood that the terminology employed is for the purpose of describing particular embodiments, and is not intended to be limiting.

Where a range of values is provided, it is understood that each intervening value, to the tenth of the unit of the lower limit unless the context clearly dictates otherwise, between the upper and lower limit of that range, and any other stated or intervening value in that stated range, is encompassed within the invention. The upper and lower limits of these smaller ranges may independently be included in the smaller ranges, and are also encompassed within the invention, subject to any specifically excluded limit in the stated range. Where the stated range includes one or both of the limits, ranges excluding either or both of those included limits are also included in the invention.

All references, patents, patent publications, articles, and databases, referred to in this application are incorporated herein by reference in their entirety, as if each were specifically and individually incorporated herein by reference. Such patents, patent publications, articles, and databases are incorporated for the purpose of describing and disclosing the subject components of the invention that are described in those patents, patent publications, articles, and databases, which components might be used in connection with the presently described invention. The information provided below is not admitted to be prior art to the present invention, but is provided solely to assist the understanding of the reader.

The details of one or more embodiments of the invention are set forth in the accompanying drawings and the description below. Other features, embodiments, and advantages of the invention will be apparent from the description and drawings, and from the claims. The preferred embodiments of the present invention may be understood more readily by reference to the following detailed description of the specific embodiments and the Examples included hereafter.

For clarity of disclosure, and not by way of limitation, the detailed description of the invention is divided into the subsections that follow.

DEFINITIONS

Unless defined otherwise, all technical and scientific terms used herein have the meaning commonly understood by one of ordinary skill in the art to which this invention belongs. Generally, the nomenclature used herein and the laboratory procedures in cell culture, molecular genetics, organic chemistry and nucleic acid chemistry described below are those well-known and commonly employed in the art. Although any methods, devices and materials similar or equivalent to those described herein can be used in the practice or testing of the invention, the preferred methods, devices and materials are now described.

In this specification and the appended claims, the singular forms “a,” “an” and “the” include plural reference unless the context clearly dictates otherwise.

The practice of the present invention will employ, unless otherwise indicated, conventional techniques of molecular biology, microbiology, recombinant DNA technology, and immunology, which are within the skill of the art. Such techniques are explained fully in the literature. See, e.g., Sambrook et al. (2001) Molecular Cloning: A Laboratory Manual, 3rd ed., Cold Spring Harbor Press; DNA Cloning, Vols. I and II (D. N. Glover ed. 1985); Oligonucleotide Synthesis (M. J. Gait ed. 1984); Nucleic Acid Hybridization (B. D. Hames & S. J. Higgins eds. 1984); Animal Cell Culture (R. K. Freshney ed. 1986); Immobilized Cells and Enzymes (IRL press, 1986); Perbal, B., A Practical Guide to Molecular Cloning (1984); the series, Methods In Enzymology (S. Colowick and N. Kaplan eds., Academic Press, Inc.); and Handbook of Experimental Immunology, Vols. I-IV (D. M. Weir and C. C. Blackwell eds., 1986, Blackwell Scientific Publications).

Before describing the present invention in detail, it is to be understood that this invention is not limited to particular DNA, polypeptide sequences or process parameters as such may, of course, vary. It is also to be understood that the terminology used herein is for the purpose of describing particular embodiments of the invention only, and is not intended to be limiting.

In describing the present invention, the following terms will be employed and are intended to be defined as indicated below.

The expression “anti-MRSA antibiotics” refers to antibiotics that one ordinarily skilled in the art would understand to be antibiotics usually used to treat antibiotic resistant infections like MRSA. Examples of such drugs include Vancomycin, Daptomycin, Linezolid, Ceftaroline, and Telavancin, among other antibiotics.

The term, “biological sample” means any material or fluid (blood, lymph, etc.) derived from the body of a subject, that contains or may contain genomic DNA (chromosomal and mitochondrial DNA) or other oligonucleotides such as, for example, mRNA that derive from genomic DNA. Also included within the meaning of the term “biological sample” is an organ or tissue extract and culture fluid in which any cells or tissue preparation from a subject has been incubated. Methods of obtaining biological samples and methods of obtaining oligonucleotide molecules such as DNA and RNA from a biological sample are well known in the art.

As used herein, the terms “complementary” or “complementarity” are used in reference to oligonucleotides related by the base-pairing rules for DNA-DNA, RNA-DNA and RNA-RNA pairing. For example, for the sequence “A-G-T,” is complementary to the sequence “T-C-A.” Complementarity may be “partial,” in which only some of the nucleic acid base pairs are matched according to the base pairing rules. Or, there may be “complete” or “total” complementarity between the nucleic acids. The degree of complementarity between nucleic acid strands has significant effects on the efficiency and strength of hybridization between nucleic acid strands. This is of particular importance in amplification reactions, as well as detection methods that depend upon binding between nucleic acids. Under “low stringency” conditions, strands with a lower degree of complementarity will hybridize with each other. Under “high stringency conditions,” only strands with a higher degree of complementarity will remain hybridized with each other.

“Complementary” may be modified, as in the term “completely complementary,” refers to an oligonucleotide where all of the nucleotides are complementary to a target sequence (e.g., a miRNA). A completely complementary oligonucleotide may be shorter than the target sequence, thus, only hybridizing to a portion of the target.

“Complementary” may be modified, as in the term “partially complementary” refers to an oligonucleotide where at least one nucleotide is not complementary to (i.e., one or more “mismatches” with) the target sequence. Preferred partially complementary oligonucleotides are those that can still hybridize to a target sequence under physiological conditions. A particular partially complementary oligonucleotide may have a ‘random’ pattern of one or more mismatches with the target sequence throughout the oligonucleotide (although the pattern of mismatches is preferentially constrained by retention of the ability to still hybridize to the target sequence under physiological conditions). A particular partially complementary oligonucleotide may have regions where the oligonucleotide sequence is highly, or even completely complementary to a target sequence, and regions where the oligonucleotide is not complementary, or is less complementary to the target sequence.

“Complementary” is illustrated, for example, partially complimentary oligonucleotides may have one or more regions that hybridize to a target sequence, and one or more regions that do not hybridize to the target sequence. Thus, a partially complementary sequence (such as a PCR or reverse transcriptase (RT) primer) may hybridize to a portion (i.e., the middle, the 5′, or 3′ end) of a particular target sequence, and not hybridize with the rest of the target sequence. Oligonucleotides with mismatches at the ends may still hybridize to the target sequence. Partially complementary sequences may be capable of binding to a sequence having less than 60%, 70%, 80%, 90%, 95%, to less than 100% identity to the target sequence. For purposes of defining or categorizing partially complementary sequences, a partially complementary sequence or region of a sequence becomes more complementary or becomes “highly complementary” as it approaches 100% complementarity to a target sequence. Thus, a highly complementary sequence may have 60%, 70%, 80%, 90%, 95%, to 99% identity to all or a portion of a target sequence. The exact percentage identity of the highly complementary sequence may depend on the length of the highly complementary sequence and the desired stringency and specificity of hybridization. Partially complementary sequences may hybridize to one or more target sequences. As we note, partially complementary sequences may be completely complementary or highly complementary to a portion of the target sequence, such that they are completely or highly complementary to, e.g., 5%, 10%, 20%, 30%, 40%, 50% 60%, 70%, 80%, 90%, 95%, 99% of the target sequence. Similarly, 5%, 10%, 20%, 30%, 40%, 50% 60%, 70%, 80%, 90%, 95%, 99% of the partially complementary sequence may be completely complementary or highly complementary to all or a portion of the target sequence.

A “cyclic polymerase-mediated reaction” refers to a biochemical reaction in which a template molecule or a population of template molecules is periodically and repeatedly copied to create a complementary template molecule or complementary template molecules, thereby increasing the number of the template molecules over time.

By the term “detectable moiety” is meant, for the purposes of the specification or claims, a label molecule (isotopic or non-isotopic) which is incorporated indirectly or directly into an oligonucleotide, wherein the label molecule facilitates the detection of the oligonucleotide in which it is incorporated, for example when the oligonucleotide is hybridized to amplified gene polymorphic sequences. Thus, “detectable moiety” is used synonymously with “label molecule”. Synthesis of oligonucleotides can be accomplished by any one of several methods known to those skilled in the art. Label molecules, known to those skilled in the art as being useful for detection, include chemiluminescent, fluorescent or luminescent molecules. Various fluorescent molecules are known in the art which are suitable for use to label a nucleic acid for the method of the present invention. The protocol for such incorporation may vary depending upon the fluorescent molecule used. Such protocols are known in the art for the respective fluorescent molecule.

A “diagnosis” of MRSA or CA-MRSA may include the early detection of the disease or a confirmation of a diagnosis of the disease that has been made from other signs and/or symptoms. A “diagnosis” can include a diagnosis of increased risk of development or recurrence of MRSA or CA-MRSA. A diagnosis may include a “prognosis,” that is, a future prediction of the progression of MRSA or CA-MRSA, based on the presence or absence of one or more SNPs associated with MRSA or CA-MRSA. A diagnosis or prognosis may be based on one or more samplings of DNA or RNA from a biological sample obtained from a subject. An “increased risk” of developing MRSA or CA-MRSA may be diagnosed by the presence of one or more SNPs characteristic of a phenotype of susceptibility to recurrent CA-MRSA in otherwise asymptomatic or undiagnosed subjects.

“DNA amplification” as used herein refers to any process that increases the number of copies of a specific DNA sequence by enzymatically amplifying the nucleic acid sequence. A variety of processes are known. One of the most commonly used is polymerase chain reaction (PCR). PCR involves the use of a thermostable DNA polymerase, known sequences as primers, and heating cycles, which separate the replicating deoxyribonucleic acid (DNA), strands and exponentially amplify a gene of interest. Any type of PCR, such as quantitative PCR, RT-PCR, hot start PCR, LAPCR, multiplex PCR, touchdown PCR, real-time PCR, etc., may be used. In general, the PCR amplification process involves a cyclic enzymatic chain reaction for preparing exponential quantities of a specific nucleic acid sequence. It requires a small amount of a sequence to initiate the chain reaction and oligonucleotide primers that will hybridize to the sequence. In PCR, the primers are annealed to denatured nucleic acid followed by extension with an inducing agent (enzyme) and nucleotides. This results in newly synthesized extension products. Since these newly synthesized sequences become templates for the primers, repeated cycles of denaturing, primer annealing, and extension results in exponential accumulation of the specific sequence being amplified. The extension product of the chain reaction will be a discrete nucleic acid duplex with a termini corresponding to the ends of the specific primers employed.

A DNA “coding sequence” or a “nucleotide sequence encoding” a particular protein is a DNA sequence that is transcribed and translated into a polypeptide in vitro or in vivo when placed under the control of appropriate regulatory elements. The boundaries of the coding sequence are determined by a start codon at the 5′ (amino) terminus and a translation stop codon at the 3′ (carboxy) terminus. A coding sequence can include, but is not limited to, prokaryotic sequences, cDNA from eukaryotic mRNA, genomic DNA sequences from eukaryotic (e.g., mammalian) DNA, and even synthetic DNA sequences. A transcription termination sequence will usually be located 3′ to the coding sequence. “Non-coding” genomic sequences may include regulatory, RNA transcription sequences (rRNA, tRNA, miRNA, etc.), introns and other non-gene sequences, such as structural sequences, putatively non-functional sequences (“junk DNA”) and the like.

The terms “enzymatically amplify”, “enzymatically amplifying”, “amplify” and “amplifying” is meant, for the purposes of the specification or claims, DNA amplification, i.e., a process by which nucleic acid sequences are amplified in number. There are several means for enzymatically amplifying nucleic acid sequences. Currently the most commonly used method is the polymerase chain reaction (PCR). Other amplification methods include LCR (ligase chain reaction) which utilizes DNA ligase, and a probe consisting of two halves of a DNA segment that is complementary to the sequence of the DNA to be amplified, enzyme QB replicase and a ribonucleic acid (RNA) sequence template attached to a probe complementary to the DNA to be copied which is used to make a DNA template for exponential production of complementary RNA; strand displacement amplification (SDA); Qβ-replicase amplification (QμRA); self-sustained replication (3 SR); and NASBA (nucleic acid sequence-based amplification), which can be performed on RNA or DNA as the nucleic acid sequence to be amplified.

A “fragment” of a molecule such as a protein or nucleic acid is meant to refer to a portion of a longer or larger amino acid or nucleotide genetic sequence.

The term “genome” refers to all the genetic material in the chromosomes of a particular organism. Its size is generally given as its total number of base pairs. Within the genome, the term “gene” refers to a locatable region of genomic sequence, corresponding to a unit of inheritance, which is associated with regulatory regions, transcribed regions and/or other functional sequence regions. “Non-gene regions” of the genome have or appear to have no functional role, but may have a structural (e.g., regions near the centromere) or unknown regulatory function. The physical development and phenotype of organisms can be thought of as a product of genes interacting with each other and with the environment. A concise definition of “gene” taking into account complex patterns of regulation and transcription, sequence conservation and non-coding RNA genes has been proposed by Gerstein et al. (Genome Research 17 (6), 669-681, 2007) “A gene is a union of genomic sequences encoding a coherent set of potentially overlapping functional products”. In general, an individual's genetic characteristics, as defined by the nucleotide sequence of its genome, are known as its “genotype,” while an individual's physical traits are described as its “phenotype.”

By “heterozygous” or “heterozygous polymorphism” is meant that the two alleles of a diploid cell or organism at a given locus are different, that is, that they have a different nucleotide exchanged for the same nucleotide at the same place in their sequences.

By “homozygous” or “homozygous polymorphism” is meant that the two alleles of a diploid cell or organism at a given locus are identical, that is, that they have the same nucleotide for nucleotide exchange at the same place in their sequences.

By “hybridization” or “hybridizing,” as used herein, is meant the formation of A-T and C-G base pairs between the nucleotide sequence of a fragment of a segment of a oligonucleotide and a complementary nucleotide sequence of an oligonucleotide. By complementary is meant that at the locus of each A, C, G or T (or U in a ribonucleotide) in the fragment sequence, the oligonucleotide sequenced has a T, G, C or A, respectively. The hybridized fragment/oligonucleotide is called a “duplex.”

A “hybridization complex”, such as in a sandwich assay, means a complex of nucleic acid molecules including at least the target nucleic acid and a sensor probe. It may also include an anchor probe.

A hybridization complex may be related to where two nucleic acid fragments are considered to be “selectively hybridizable” to a oligonucleotide if they are capable of specifically hybridizing to a nucleic acid or a variant thereof or specifically priming a polymerase chain reaction: (i) under typical hybridization and wash conditions, as described, for example, in Sambrook et al. supra and Nucleic Acid Hybridization, supra, (ii) using reduced stringency wash conditions that allow at most about 25-30% base pair mismatches, for example: 2×SSC, 0.1% SDS, room temperature twice, 30 minutes each; then 2×SSC, 0.1% SDS, 37° C. once, 30 minutes; then 2×SSC room temperature twice, 10 minutes each, or (iii) selecting primers for use in typical polymerase chain reactions (PCR) under standard conditions (described for example, in Saiki, et al. (1988) Science 239:487-491).

A hybridization complex may be ratted to the term “capable of hybridizing under stringent conditions” as used herein refers to annealing a first nucleic acid to a second nucleic acid under stringent conditions as defined below. Stringent hybridization conditions typically permit the hybridization of nucleic acid molecules having at least 70% nucleic acid sequence identity with the nucleic acid molecule being used as a probe in the hybridization reaction. For example, the first nucleic acid may be a test sample or probe, and the second nucleic acid may be the sense or antisense strand of a nucleic acid or a fragment thereof. Hybridization of the first and second nucleic acids may be conducted under stringent conditions, e.g., high temperature and/or low salt content that tend to disfavor hybridization of dissimilar nucleotide sequences. Alternatively, hybridization of the first and second nucleic acid may be conducted under reduced stringency conditions, e.g. low temperature and/or high salt content that tend to favor hybridization of dissimilar nucleotide sequences. Low stringency hybridization conditions may be followed by high stringency conditions or intermediate medium stringency conditions to increase the selectivity of the binding of the first and second nucleic acids. The hybridization conditions may further include reagents such as, but not limited to, dimethyl sulfoxide (DMSO) or formamide to disfavor still further the hybridization of dissimilar nucleotide sequences. A suitable hybridization protocol may, for example, involve hybridization in 6×SSC (wherein 1×SSC comprises 0.015 M sodium citrate and 0.15 M sodium chloride), at 65° Celsius in an aqueous solution, followed by washing with 1×SSC at 65° C. Formulae to calculate appropriate hybridization and wash conditions to achieve hybridization permitting 30% or less mismatch between two nucleic acid molecules are disclosed, for example, in Meinkoth et al. (1984) Anal. Biochem. 138: 267-284; the content of which is herein incorporated by reference in its entirety. Protocols for hybridization techniques are well known to those of skill in the art and standard molecular biology manuals may be consulted to select a suitable hybridization protocol without undue experimentation. See, for example, Sambrook et al. (2001) Molecular Cloning: A Laboratory Manual, 3rd ed., Cold Spring Harbor Press, the contents of which are herein incorporated by reference in their entirety.

A hybridization complex may refer to “stringent conditions” which typically will be those in which the salt concentration is less than about 1.5 M sodium ion, typically about 0.01 to 1.0 M Na ion concentration (or other salts) from about pH 7.0 to about pH 8.3 and the temperature is at least about 30° Celsius for short probes (e.g., 10 to 50 nucleotides) and at least about 60° C. for long probes (e.g., greater than 50 nucleotides). Stringent conditions may also be achieved with the addition of destabilizing agents such as formamide. Exemplary low stringency conditions include hybridization with a buffer solution of 30 to 35% formamide, 1 M NaCl, 1% SDS (sodium dodecyl sulfate) at 37° Celsius, and a wash in 1-2×SSC at 50 to 55° Celsius. Exemplary moderate stringency conditions include hybridization in 40 to 45% formamide, 1 M NaCl, 1% SDS at 37° Celsius, and a wash in 0.5-1×SSC at 55 to 60° Celsius. Exemplary high stringency conditions include hybridization in 50% formamide, 1 M NaCl, 1% SDS at 37° Celsius, and a wash in 0.1×SSC at 60 to 65° Celsius.

An “isolated” oligonucleotide or polypeptide is one that is substantially pure of the materials with which it is associated in its native environment. By substantially free, is meant at least 50%, at least 55%, at least 60%, at least 65%, at advantageously at least 70%, at least 75%, more advantageously at least 80%, at least 85%, even more advantageously at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, most advantageously at least 98%, at least 99%, at least 99.5%, at least 99.9% free of these materials.

An “isolated” nucleic acid molecule is a nucleic acid molecule separate and discrete from the whole organism with which the molecule is found in nature; or a nucleic acid molecule devoid, in whole or part, of sequences normally associated with it in nature; or a sequence, as it exists in nature, but having heterologous sequences (as defined below) in association therewith.

As used herein, the term “locus” or “loci” refers to the location of a coding, regulatory or non-coding region on a chromosome. Absolute location of a region may be known to more or less precision (i.e., a locus is known to be located within a chromosome, chromosome arm, chromosome band, or to the nearest kilobase or base pair of a chromosome) due to the fact that genome length may differ slightly between individuals or the precise location of a locus is not known. A relative location may also be specified where a locus is located within a sequenced fragment of a chromosome. Pairs of genes, known as “alleles” may be present for a particular locus in organisms, such as humans, that are diploid (usually contain two copies of most chromosomes) in most cells and tissues. An individual's particular combination of alleles is referred to as its “genotype”. Where both alleles are identical the individual is said to be homozygous for the trait controlled by that gene pair; where the alleles are different, the individual is said to be heterozygous for the trait. While inclusive of loci within coding regions, an “allele” may also be present at locations in non-coding regions. Certain organisms, cells or tissues may be haploid or polyploid (triploid, etc.) and have more or less than two alleles at a particular locus.

A “melting temperature” is meant the temperature at which hybridized oligonucleotide duplexes dehybridize and return to their single-stranded state. Likewise, hybridization will not occur in the first place between two oligonucleotides, or, herein, an oligonucleotide and a fragment, at temperatures above the melting temperature of the resulting duplex. It is presently advantageous that the difference in melting point temperatures of oligonucleotide-fragment duplexes of this invention be from about 1 degree C. to about 10 degrees C. so as to be readily detectable.

The term, “MRSA” means Methicillin-resistant S. aureus, it is a strain of S. aureus that has become resistant to methicillin, an antibiotic commonly used to treat ordinary S. aureus infections. When MRSA is acquired or develops in medical care facilities, such as hospitals, it is known as health care-associated MRSA (HA-MRSA). When MRSA develops in otherwise healthy people not exposed to hospital situations it is termed community-acquired MRSA (CA-MRSA). Here it should be understood that Methicillin-resistant S. aureus or MRSA includes HA-MRSA and CA-MRSA.

As used herein, the term “nucleic acid molecule” is intended to include DNA molecules (e.g., cDNA or genomic DNA), RNA molecules (e.g., mRNA), analogs of the DNA or RNA generated using nucleotide analogs, and derivatives, fragments and homologs thereof. The nucleic acid molecule can be single-stranded or double-stranded, but advantageously is double-stranded DNA. “DNA” refers to the polymeric form of deoxyribonucleotides (adenine, guanine, thymine, or cytosine) in its either single stranded form, or a double-stranded helix. This term refers only to the primary and secondary structure of the molecule, and does not limit it to any particular tertiary forms. Thus, this term includes double-stranded DNA found, inter alia, in linear DNA molecules (e.g., restriction fragments), viruses, plasmids, and chromosomes. In discussing the structure of particular double-stranded DNA molecules, sequences may be described herein according to the normal convention of giving only the sequence in the 5′ to 3′ direction along the nontranscribed strand of DNA (i.e., the strand having a sequence homologous to the mRNA). An “isolated” nucleic acid molecule is one that is separated from other nucleic acid molecules that are present in the natural source of the nucleic acid.

A “nucleoside” refers to a base linked to a sugar. The base may be adenine (A), guanine (G) (or its substitute, inosine (I)), cytosine (C), or thymine (T) (or its substitute, uracil (U)). The sugar may be ribose (the sugar of a natural nucleotide in RNA) or 2-deoxyribose (the sugar of a natural nucleotide in DNA). A “nucleotide” refers to a nucleoside linked to a single phosphate group.

The term “oligonucleotide” refers to a series of linked nucleotide residues. The series of nucleotide residues are connected by a phosphodiester linkage between the 3′-hydroxyl group of one nucleoside and the 5′-hydroxyl group of a second nucleoside which in turn is linked through its 3′-hydroxyl group to the 5′-hydroxyl group of a third nucleoside and so on to form a polymer comprised of nucleosides linked by a phosphodiester backbone. Oligonucleotides may be used, for example, as primers in a PCR reaction, or as probes to detect the presence of a certain sequence in or within a nucleic acid molecule. A short oligonucleotide sequence may be based on, or designed from, a genomic or cDNA sequence and is used to amplify, confirm, or reveal the presence of an identical, similar or complementary DNA or RNA in a particular cell or tissue. Oligonucleotides may be chemically synthesized and may be used as primers or probes. A “modified oligonucleotide” refers to an oligonucleotide in which one or more natural nucleotides have been partially, substantially, or completely replaced with modified nucleotides.

The term “oligonucleotide encoding a protein” as used herein refers to a DNA fragment or isolated DNA molecule encoding a protein, or the complementary strand thereto; but, RNA is not excluded, as it is understood in the art that thymidine (T) in a DNA sequence is considered equal to uracil (U) in an RNA sequence. Thus, RNA sequences for use in the invention, e.g., for use in RNA vectors, can be derived from DNA sequences, by thymidine (T) in the DNA sequence being considered equal to uracil (U) in RNA sequences.

The following are non-limiting examples of oligonucleotides: a gene or gene fragment, exons, introns, mRNA, tRNA, rRNA, ribozymes, cDNA, recombinant oligonucleotides, branched oligonucleotides, plasmids, vectors, isolated DNA of any sequence, isolated RNA of any sequence, nucleic acid probes and primers. A oligonucleotide may comprise modified nucleotides, such as methylated nucleotides and nucleotide analogs, uracil, other sugars and linking groups such as fluororibose and thiolate, and nucleotide branches. The sequence of nucleotides may be further modified after polymerization, such as by conjugation, with a labeling component. Other types of modifications included in this definition are caps, substitution of one or more of the naturally occurring nucleotides with an analog, and introduction of means for attaching the oligonucleotide to proteins, metal ions, labeling components, other oligonucleotides or solid support.

“Percent identity” can be determined by hybridization of oligonucleotides under conditions that form stable duplexes between similar regions, followed by digestion with single-stranded-specific nuclease(s), and size determination of the digested fragments. DNA sequences that are homologous can be identified in a Southern hybridization experiment under, for example, stringent conditions, as defined for that particular system. Defining appropriate hybridization conditions is within the skill of the art. See, e.g., Sambrook et al. supra; DNA Cloning, supra; Nucleic Acid Hybridization, supra.

A “polymerase” is an enzyme that catalyzes the sequential addition of monomeric units to a polymeric chain, or links two or more monomeric units to initiate a polymeric chain. The “polymerase” will work by adding monomeric units whose identity is determined by and which is complementary to a template molecule of a specific sequence. For example, DNA polymerases such as DNA pol 1 and Taq polymerase add deoxyribonucleotides to the 3′ end of a oligonucleotide chain in a template-dependent manner, thereby synthesizing a nucleic acid that is complementary to the template molecule. Polymerases may be used either to extend a primer once or repetitively or to amplify an oligonucleotide by repetitive priming of two complementary strands using two primers. A “thermostable polymerase” refers to a DNA or RNA polymerase enzyme that can withstand extremely high temperatures, such as those approaching 100° C. Often, thermostable polymerases are derived from organisms that live in extreme temperatures, such as Thermus aquaticus. Examples of thermostable polymerases include Taq, Tth, Pfu, Vent, deep vent, UlTma, and variations and derivatives thereof.

A “primer” is an oligonucleotide, the sequence of at least of portion of which is complementary to a segment of a template DNA which is to be amplified or replicated. Typically primers are used in performing the polymerase chain reaction (PCR). A primer hybridizes with (or “anneals” to) the template DNA and is used by the polymerase enzyme as the starting point for the replication/amplification process. The primers herein are selected to be “substantially” complementary to different strands of a particular target DNA sequence. This means that the primers must be sufficiently complementary to hybridize with their respective strands. Therefore, the primer sequence need not reflect the exact sequence of the template. For example, a non-complementary nucleotide fragment may be attached to the 5′ end of the primer, with the remainder of the primer sequence being complementary to the strand. Alternatively, non-complementary bases or longer sequences can be interspersed into the primer, provided that the primer sequence has sufficient complementarity with the sequence of the strand to hybridize therewith and thereby form the template for the synthesis of the extension product.

“Probes” refer to oligonucleotides nucleic acid sequences of variable length, used in the detection of identical, similar, or complementary nucleic acid sequences by hybridization. An oligonucleotide sequence used as a detection probe may be labeled with a detectable moiety.

“Sequence identity” refers to the percent identity between two oligonucleotide or two polypeptide moieties. Genes that share a high sequence identity or similarity support the hypothesis that they share a common ancestor and are therefore homologous. Sequence homology may also indicate common function. Two DNA, or two polypeptide sequences are similar to each other and may be homologous when the sequences exhibit at least about 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, preferably at least about 90%, 91%, 92%, 93%, 94% and most preferably at least about 95%, 96%, 97%, 98%, 99%, 99.5%, 99.9% sequence identity over a defined length of the molecules. As used herein, sequence identity also refers to sequences showing complete identity (100% sequence identity) to the specified DNA or polypeptide sequence.

A “restriction fragment” refers to a fragment of a oligonucleotide generated by a restriction endonuclease (an enzyme that cleaves phosphodiester bonds within a oligonucleotide chain) that cleaves DNA in response to a recognition site on the DNA. The recognition site (restriction site) consists of a specific sequence of nucleotides typically about 4-8 nucleotides long.

A “template” refers to a target oligonucleotide strand, for example, without limitation, an unmodified naturally-occurring DNA strand, which a polymerase uses as a means of recognizing which nucleotide it should next incorporate into a growing strand to polymerize the complement of the naturally-occurring strand. Such a DNA strand may be single-stranded or it may be part of a double-stranded DNA template. In applications of the present invention requiring repeated cycles of polymerization, e.g., the polymerase chain reaction (PCR), the template strand itself may become modified by incorporation of modified nucleotides, yet still serve as a template for a polymerase to synthesize additional oligonucleotides.

A “thermocyclic reaction” is a multi-step reaction wherein at least two steps are accomplished by changing the temperature of the reaction.

A “variance” is a difference in the nucleotide sequence among related oligonucleotides. The difference may be the deletion of one or more nucleotides from the sequence of one oligonucleotide compared to the sequence of a related oligonucleotide, the addition of one or more nucleotides or the substitution of one nucleotide for another. The terms “mutation,” “polymorphism” and “variance” are used interchangeably herein. As used herein, the term “variance” in the singular is to be construed to include multiple variances; i.e., two or more nucleotide additions, deletions and/or substitutions in the same oligonucleotide.

A “single nucleotide polymorphism” or “SNP” refers to a variation in the nucleotide sequence of an oligonucleotide that differs from another related oligonucleotide by a single nucleotide difference. For example, without limitation, exchanging one A for one C, G or T in the entire sequence of oligonucleotide constitutes a SNP. It is possible to have more than one SNP in a particular oligonucleotide. For example, at one position in an oligonucleotide, a C may be exchanged for a T, at another position a G may be exchanged for an A and so on. When referring to SNPs, the oligonucleotide is most often DNA. SNPs can be found in coding regions of the genome (i.e., within an exon) or non-coding intragenic (i.e., in an intron) or intergenic regions.

RNA sequences within the scope of the invention are derived from the DNA sequences, by thymidine (T) in the DNA sequence being considered equal to uracil (U) in RNA sequences.

“Subject” or “Patient” as used herein refers to a mammal, preferably a human, in need of diagnosis and/or treatment for a condition, disorder or disease.

Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art of molecular biology. Although methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present invention, suitable methods and materials are described herein.

Single Nucleotide Polymorphisms

Analysis of single nucleotide polymorphisms (SNPs) have proved to be effective in discovering genomic differences (i.e., genotypes) in individuals or populations exhibiting different phenotypes, such as susceptibility or increased risk of contracting certain diseases or syndromes. With the advent of rapid sequencing, amplification and high throughput screening of oligonucleotides, analysis of SNPs can be used to probe individual and population genomes for one or more SNPs that correlate with (are “markers” for) the presence of a certain phenotype. Discovery of one or more reliably correlating markers (among other uses) allows for early diagnosis of potential susceptibility or risk for certain diseases, even where a phenotype is not yet being exhibited in a particular individual, e.g., a late-onset cancer or susceptibility to a disease organism prior to exposure. Here, we disclose that a SNP at a loci corresponding to position 17 of SEQ ID. NOs 1 or 2 (the FAM129B gene) can be manipulated, evaluated and then used to differentiate, identify and in some cases treat subjects who are at increased risk of MRSA and/or CA-MRSA, or a recurrence of MRSA or CA-MRSA.

Often, SNP detection methods can distinguish between homozygous and heterozygous individuals. The presence of zero, zero or one, one, one or two, or two copies of a particular base substitution allele may correlate with a particular phenotype. “Dominant,” “recessive” and “intermediate dominance”/“incomplete dominance” of a particular allele at a locus can be defined as the relative contribution of each allele to the phenotype of a heterozygous individual. For example, where a heterozygous individual carrying one copy of allele A and one copy of allele A′ has the same phenotype as a homozygous AA individual, and a different phenotype from a homozygous A′A′ individual, allele A is dominant over allele A′. Where a heterozygous individual AA′ exhibits a different or intermediate phenotype between the homozygote phenotypes, allele A′ and A are said to exhibit an intermediate or incomplete dominance.

While SNPs occur at particular locations in the genome, presentation, identification and comparison of the location of particular SNPs is aided by inclusion of the sequence of nucleotides immediately upstream and downstream in the genome. SNP detection methods using oligonucleotide hybridization methods may use the same sequence as presented herein as all or part of a primer or probe sequence, and thus such sequences may serve as examples of an appropriate primer or probes for these methods. Persons of skill in the art realize that design of appropriate primers and probes, examples of which are provided below, are not necessarily limited to the sequences listed herein for purposes of presentation, and may be longer or shorter, and include more or less of the upstream and downstream flanking sequence(s), as long as they encompass the location of a SNP.

Methods and materials of the invention may be used more generally to evaluate a DNA sample from a subject, genetically type the subject, and detect genetic differences between subjects. In one embodiment of the invention, a biological sample which includes DNA from a subject is evaluated to detect the genotype of the subject for a nucleotide that occurs at a loci corresponding to position 17 of SEQ ID. NOs 1 or 2. A sample of genomic DNA from a subject may be evaluated by reference to one or more controls to determine if a SNP or group of SNPs is present. With this present invention, any method for determining genotype can be used for determining the genotype of the subject. Such methods include, but are not limited to, amplimer sequencing, DNA sequencing, fluorescence spectroscopy, fluorescence resonance energy transfer (or “FRET”)-based hybridization analysis, high throughput screening, mass spectroscopy, microsatellite analysis, nucleic acid hybridization, polymerase chain reaction (PCR), RFLP analysis and size chromatography (e.g., capillary or gel chromatography), all of which are well known to one of skill in the art. In particular, methods for determining nucleotide polymorphisms, particularly single nucleotide polymorphisms, are described in U.S. Pat. Nos. 6,514,700; 6,503,710; 6,468,742; 6,448,407; 6,410,231; 6,383,756; 6,358,679; 6,322,980; 6,316,230; and 6,287,766 and reviewed by Chen and Sullivan, Pharmacogenomics J 2003; 3(2):77-96, the disclosures of which are incorporated by reference in their entireties. Genotypic data useful in the methods of the invention and methods for the identification and selection of genes associated with CA-MRSA are based on the presence of SNPs.

A Single Nucleotide Polymorphism Associated with CA-MRSA

Genomic DNA was obtained from a population of patients with recurrent CA-MRSA as well as from healthy spouse controls, who were likely to have been exposed to the same MRSA bacteria as the recurrent CA-MRSA patients. A microarray hybridization assay for single nucleotide polymorphism (SNP) alleles that segregated between the CA-MRSA and control populations was performed that was capable of detecting the presence of 906,000 known polymorphisms as well as their copy number in each subject (i.e., that could detect, whether the subject had multiple gene copies, and whether the subject was homozygous or heterozygous for particular allele(s) at a particular locus.)

A highly segregated SNP was found in the FAM129B gene, where all CA-MRSA subjects tested had two copies (homozygous) of one allele and control subjects had two copies (homozygous) of another allele. This SNP is present at a loci corresponding to position 17 of SEQ ID NOs. 1 and 2, wherein each of SEQ ID NOs. 1 and 2 identify an alternate oligonucleotide at that position. More specifically, SEQ ID NO. 1 identifies an “A” (adenine) at position 17 and SEQ ID NO. 2 identifies a “C” (cytosine) at position 17. This SNP is located in an intron of the FAM129B gene. SEQ ID NOs. 1 and 2 generally correspond with positions 17444-17464 of SEQ ID NO. 3, the full-length DNA sequence of the FAM129B gene.

Subjects with at least one or more copies of the allele corresponding to position 17 of SEQ ID. NO 1 are at increased risk of developing at developing MRSA and/or CA-MRSA, or a recurrence of MRSA or CA-MRSA. And subjects with at least one or more copies of the allele corresponding to position 17 of SEQ ID. NO 2 are not at increased risk of developing at developing MRSA and/or CA-MRSA, or a recurrence of MRSA or CA-MRSA.

The FAM129B gene encodes a protein that has a predicted molecular mass of 83 kDa, and contains a pleckstrin homology domain and a proline-rich region that contains six serine phosphorylation sites (Chen et al (2011) J. Biol. Chem. 286(12):10201-10209; Old et al. (2009) Mol. Cell 34: 115-131). Phosphorylation has been associated with MAP kinase signaling cascade; in melanoma cells the MAP kinase pathway was active and the FAM129B protein was localized throughout the cytoplasm. When the MAP kinase pathway was inhibited, the FAM129B protein migrated to the cell membrane and melanoma cell migration through a collagen matrix was inhibited. (Old et al., p. 125). Subsequent work found that FAM129B was cytoplasmically localized in actively growing HeLa cells, but appeared to be localized at cell-cell junctions on the plasma membrane when the HeLa cells achieved confluence, and throughout the cell membrane during telophase. (Chen et al. pp. 10203-10204.) FAM129B also inhibited apoptosis in HeLa cells treated with TNFα or CHX, compared with knockdown FAM129B HeLa cells silenced with siRNA sequences specific to FAM129B. A recent investigation of the corresponding Fam129B protein in mice showed that Fam129B is expressed in the epidermal keratinocytes in embryonic and adult mice. Fam129B-knockout mice exhibited delayed wound healing and had altered expression of several wound-repair and cell-motility related genes (Oishi et al. (published online Sep. 11, 2012), J. Biochem. doi:10.1093/jb/mvs 100).

Methods of Diagnosing Increased Risk of Developing MRSA

Aspects of the present invention comprise methods of determining whether a subject is at increased risk of developing MRSA or CA-MRSA, or a recurrence of MRSA or CA-MRSA, comprising: obtaining a biological sample from a subject; obtaining at least one oligonucleotide from said biological sample that contains a loci corresponding to position 17 of SEQ ID. NOs 1 and 2; detecting in the oligonucleotide the identity of a nucleotide that occurs at a loci corresponding to position 17 of SEQ ID. NOs 1 and 2; and comparing the identity of the nucleotide that occurs at a loci corresponding to position 17 of SEQ ID. NOs 1 and 2 in the oligonucleotide to the identity of a nucleotide at position 17 of SEQ ID. NO 1 and/or SEQ ID. NO 2, wherein the subject is at increased risk of developing MRSA and/or CA-MRSA, or a recurrence of MRSA or CA-MRSA if the nucleotide that occurs at the loci corresponding to position 17 of SEQ ID. NOs 1 and 2 in the oligonucleotide is the same as the identity of the nucleotide at position 17 of SEQ ID NO 1, and wherein the subject is not at increased risk of developing MRSA and/or CA-MRSA, or a recurrence of MRSA or CA-MRSA if the nucleotide that occurs at the loci corresponding to position 17 of SEQ ID. NOs 1 and 2 in the oligonucleotide is the same as the identity of the nucleotide at position 17 of SEQ ID NO 2.

Obtaining Oligonucleotides from Subjects.

Biological samples may be any material or fluid (blood, lymph, etc.) derived from the body of a subject, that contains or may contain genomic DNA (chromosomal and mitochondrial DNA) or other oligonucleotides such as, for example, mRNA that derive from genomic DNA, or an organ or tissue extract and culture fluid in which any cells or tissue preparation from a subject has been incubated. Methods of obtaining biological samples and methods of obtaining oligonucleotide molecules such as DNA and RNA from a biological sample are well known in the art, such as blood draws, cheek cell swabs, biopsies and the like.

For purposes of obtaining at least one oligonucleotide from said biological sample that contains a loci corresponding to position 17 of SEQ ID. NO 1 and 2, DNA or other oligonucleotides, such as pre-mRNA, can be extracted or partially purified from the biological sample for further processing by techniques known to those skilled in the art (see, e.g., U.S. Pat. Nos. 6,548,256 and 5,989,431; Hirota et al. (1989) Jinrui Idengaku Zasshi. 34: 217-23 and John et al. (1991) Nucleic Acids Res. 19:408, the disclosures of which are incorporated by reference in their entireties). For example, high molecular weight DNA may be purified from cells or tissue using proteinase K extraction and ethanol precipitation. DNA, however, may be extracted from an animal specimen using any other suitable methods known in the art.

Alternatively, a purification step may be not be needed where probes such as those described below may operate to detect the presence of a SNP by directly hybridizing to genomic DNA in situ in the biological sample, such that obtaining at least one oligonucleotide from said biological sample that contains a loci corresponding to position 17 of SEQ ID. NO 1 and 2 may occur without an oligonucleotide extraction step from the biological sample. The biological sample may be partially processed (i.e., homogenization, partial purification) prior to hybridization to facilitate the hybridization step.

Detecting SNP Polymorphisms

Any method of detecting the identity of individual nucleotides at SNP loci may be used to practice this invention.

In one aspect, detecting the identity of the SNP corresponding to position 17 of SEQ ID NOs:1 and 2 of the present invention may be performed by sequencing the region of the genomic DNA sample that spans the FAM 129B polymorphic locus. Many methods of sequencing genomic DNA are known in the art, and any such method can be used, see for example, Sambrook et al. (2001) Molecular Cloning: A Laboratory Manual, 3rd ed., Cold Spring Harbor Press. For instance, as described below, a DNA restriction fragment spanning the location of the SNP of interest can be amplified using the polymerase chain reaction, then subjected to further genomic sequencing methods.

In other aspects, detecting the identity of the SNP corresponding to position 17 of SEQ ID NOs:1 and 2 of the present invention may be performed by the use of allele-specific probes that hybridize to a region of DNA containing the allele of interest. The probes may be further tagged with a detection signal to aid in detecting the presence of the allele in the biological sample. Probes and detection signals are described below.

A. Amplification

A genomic oligonucleotide spanning the location of the SNP of interest in the FAM129B gene may also be amplified as part of the detection step. More specifically, detecting the identity of SNP of the present invention may comprise DNA amplification to amplify specific, genomic sequences containing the SNP correlated to healthy and/or recurrent CA-MRSA subject phenotypes, by one of several known methods of DNA amplification, such as PCR. As noted above, the PCR amplification process involves a cyclic enzymatic chain reaction for preparing exponential quantities of a specific nucleic acid sequence. It requires a small amount of a sequence to initiate the chain reaction and oligonucleotide primers that will hybridize to the sequence. In PCR the primers are annealed to denatured nucleic acid followed by extension with an inducing agent (enzyme) and nucleotides. This results in newly synthesized extension products. Since these newly synthesized sequences become templates for the primers, repeated cycles of denaturing, primer annealing, and extension results in exponential accumulation of the specific sequence being amplified. The extension product of the chain reaction will be a discrete nucleic acid duplex with a termini corresponding to the ends of the specific primers employed.

The methods of the present invention may use oligonucleotide primers to amplify specific, genomic sequences containing the SNP correlated to healthy and/or recurrent CA-MRSA subject phenotypes. Such primers should be of sufficient length to enable specific annealing or hybridization to the nucleic acid sample. The sequences typically will be about 8 to about 44 nucleotides in length. Longer sequences, e.g., from about 14 to about 50, may be advantageous for certain embodiments. The design of primers is well known to one of ordinary skill in the art. Primers may comprise sequences upstream or downstream of the location of the SNP, but not contain the SNP itself (begin or end at, e.g., 1-1000 base pairs upstream or downstream of the location of the SNP), or comprise a sequence comprising the SNP. Such primers may be used to specifically amplify one allele or another at that SNP location. In any case, primers should be designed such that the SNP is contained within the amplified sequence. For instance, suitable primers may be designed using sequences within SEQ ID NO:3 (the FAM129B gene) upstream or downstream from the location of the SNP at position 17 of SEQ ID NOs 1 and 2.

Where it is desired to amplify a fragment of DNA that comprises a SNP according to the present invention, the forward and reverse primers may have contiguous stretches of about 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 or any other length up to and including about 50 nucleotides in length. The sequences to which the forward and reverse primers anneal are advantageously located on either side of the particular nucleotide position that is substituted in the SNP to be amplified (e.g., position 17 of SEQ ID NOs 1 and 2).

Oligonucleotide primers can be produced by a conventional production process for general oligonucleotides. They can be produced, for example, by a chemical synthesis process or by a microbial process that makes use of a plasmid vector, a phage vector or the like. Further, it is suitable to use a nucleic acid synthesizer.

B. Oligonucleotide Sequencing

As noted above, detecting the identity of the SNP corresponding to position 17 of SEQ ID NOs. 1 and 2 of the present invention may be performed by sequencing the region of the genomic DNA sample that spans the FAM 129B polymorphic locus. Reagents allowing the sequencing of reaction products can be utilized herein. For example, chain-terminating nucleotides will often be incorporated into a reaction product during one or more cycles of a reaction. Commercial kits containing the reagents most typically used for these methods of DNA sequencing are available and widely used. PCR exonuclease digestion methods for DNA sequencing can also be used. Many methods of sequencing genomic DNA are known in the art, and any such method can be used, see for example Sambrook et al. (2001) Molecular Cloning: A Laboratory Manual, 3rd ed., Cold Spring Harbor Press. For example, as described below, a DNA fragment spanning the location of the SNP of interest can be amplified using the polymerase chain reaction or some other cyclic polymerase mediated amplification reaction. The amplified region of DNA can then be sequenced using any method known in the art. Advantageously, the nucleic acid sequencing is by automated methods (reviewed by Meldrum, (2000) Genome Res. 10: 1288-303, the disclosure of which is incorporated by reference in its entirety), for example using a Beckman CEQ 8000 Genetic Analysis System (Beckman Coulter Instruments, Inc.). Methods for sequencing nucleic acids include, but are not limited to, automated fluorescent DNA sequencing (see, e.g., Watts & MacBeath, (2001) Methods Mol. Biol. 167: 153-70 and MacBeath et al. (2001) Methods Mol. Biol. 167:119-52), capillary electrophoresis (see, e.g., Bosserhoff et al. (2000) Comb Chem High Throughput Screen. 3: 455-66), DNA sequencing chips (see, e.g., Jain, (2000) Pharmacogenomics. 1: 289-307), mass spectrometry (see, e.g., Yates, (2000) Trends Genet. 16: 5-8), pyrosequencing (see, e.g., Ronaghi, (2001) Genome Res. 11: 3-11), and ultrathin-layer gel electrophoresis (see, e.g., Guttman & Ronai, (2000) Electrophoresis. 21: 3952-64), the disclosures of which are hereby incorporated by reference in their entireties. The sequencing can also be done by a commercial company. Examples of such companies include, but are not limited to, the University of Georgia Molecular Genetics Instrumentation Facility (Athens, Ga.) or SeqWright DNA Technologies Services (Houston, Tex.).

C. Oligonucleotide Hybridization

Detecting the identity of a SNP corresponding to position 17 of SEQ ID NOs. 1 and 2 of the present invention may be performed by the use of allele-specific probes that hybridize to a region of DNA containing the allele of interest.

One example method for determining the genotype at the polymorphic locus encompasses obtaining a biological sample that includes a nucleic acid sample, hybridizing the nucleic acid sample with a probe, and disrupting the hybridization to determine the level of disruption energy required wherein the probe has a different disruption energy for one allele as compared to another allele. In one example, there can be a lower disruption energy, e.g., melting temperature, for an allele that harbors a cytosine residue at a polymorphic locus, and a higher required energy for an allele with a different residue at that polymorphic locus. This can be achieved where the probe has 100% sequence identity with one allele (a perfectly matched probe), but has a single mismatch with the alternative allele. Since the perfectly matched probe is bound more tightly to the target DNA than the mismatched probe, it requires more energy to cause the hybridized probe to dissociate.

In a further step of the above method, a second (“anchor”) probe may be used. Generally, the anchor probe is not specific to either allele, but hybridizes regardless of what nucleotide is present at the polymorphic locus. The anchor probe does not affect the disruption energy required to disassociate the hybridization complex but, instead, contains a complementary label for using with the first (“sensor”) probe.

Hybridization stability may be influenced by numerous factors, including thermoregulation, chemical regulation, as well as electronic stringency control, either alone or in combination with the other listed factors. Through the use of stringency conditions, in either or both of the target hybridization step or the sensor oligonucleotide stringency step, rapid completion of the process may be achieved. This is desirable to achieve properly indexed hybridization of the target DNA to attain the maximum number of molecules at a test site with an accurate hybridization complex. By way of example, with the use of stringency, the initial hybridization step may be completed in ten minutes or less, more advantageously five minutes or less, and most advantageously two minutes or less. Overall, the analytical process may be completed in less than half an hour.

In one mode, the hybridization complex is labeled and the step of determining the amount of hybridization includes detecting the amounts of labeled hybridization complex at the test sites. The detection device and method may include, but is not limited to, optical imaging, electronic imaging, imaging with a CCD camera, integrated optical imaging, and mass spectrometry. Further, the amount of labeled or unlabeled probe bound to the target may be quantified. Such quantification may include statistical analysis. The labeled portion of the complex may be the target, the stabilizer, the probe or the hybridization complex in toto. Labeling may be by fluorescent labeling selected from the group of, but not limited to, Cy3, Cy5, Bodipy Texas Red, Bodipy Far Red, Lucifer Yellow, Bodipy 630/650-X, Bodipy R6G-X and 5-CR 6G. Colorimetric labeling, bioluminescent labeling and/or chemiluminescent labeling may further accomplish labeling. Labeling further may include energy transfer between molecules in the hybridization complex by perturbation analysis, quenching, electron transport between donor and acceptor molecules, the latter of which may be facilitated by double stranded match hybridization complexes. Optionally, if the hybridization complex is unlabeled, detection may be accomplished by measurement of conductance differential between double stranded and non-double stranded DNA. Further, direct detection may be achieved by porous silicon-based optical interferometry or by mass spectrometry. In using mass spectrometry no fluorescent or other label is necessary. Rather detection is obtained by extremely high levels of mass resolution achieved by direct measurement, for example, by time of flight (TOF) or by electron spray ionization (ESI). Where mass spectrometry is contemplated, probes having a nucleic acid sequence of 50 bases or less are advantageous.

The label may be amplified, and may include, for example, branched or dendritic DNA. If the target DNA is purified, it may be un-amplified or amplified. Further, if the purified target is amplified and the amplification is an exponential method, it may be, for example, PCR amplified DNA or strand displacement amplification (SDA) amplified DNA. Linear methods of DNA amplification such as rolling circle or transcriptional runoff may also be used.

A detectable label can be incorporated into a nucleic acid during at least one cycle of an amplification reaction. Spectroscopic, photochemical, biochemical, immunochemical, electrical, optical or chemical means can detect such labels. Useful labels in the present invention include fluorescent dyes (e.g., fluorescein isothiocyanate, Texas red, rhodamine, and the like), radiolabels (e.g., ³H, ¹²⁵I, ³⁵S, ¹⁴C, ³²P, etc.), enzymes (e.g., horseradish peroxidase, alkaline phosphatase etc.), calorimetric labels such as colloidal gold or colored glass or plastic (e.g., polystyrene, polypropylene, latex, etc.) beads. The label is coupled directly or indirectly to a component of the assay according to methods well known in the art. As indicated above, a wide variety of labels are used, with the choice of label depending on sensitivity required, ease of conjugation with the compound, stability requirements, available instrumentation, and disposal provisions. Non-radioactive labels are often attached by indirect means. Polymerases can also incorporate fluorescent nucleotides during synthesis of nucleic acids.

To label an oligonucleotide with the fluorescent dye, one of several conventionally known labeling methods can be used (Tyagi & Kramer (1996) Nature Biotechnology 14: 303-308; Schofield et al. (1997) Appl. and Environ. Microbiol. 63: 1143-1147; Proudnikov & Mirzabekov (1996) Nucl. Acids Res. 24: 4532-4535). Alternatively, the oligonucleotide may be labeled with a radiolabel e.g., ³H, ¹²⁵I, ³⁵S, ¹⁴C, ³²P, etc. Well-known labeling methods are described, for example, in Sambrook et al. (2001) Molecular Cloning: A Laboratory Manual, 3rd ed., Cold Spring Harbor Press. The label is coupled directly or indirectly to a component of the oligonucleotide according to methods well known in the art. Reversed phase chromatography or the like used to provide a nucleic acid probe for use in the present invention can purify the synthesized oligonucleotide labeled with a marker. An advantageous probe form is one labeled with a fluorescent dye at the 3′- or 5′-end and containing G or C as the base at the labeled end. If the 5′-end is labeled and the 3′-end is not labeled, the OH group on the C atom at the 3′-position of the 3′-end ribose or deoxyribose may be modified with a phosphate group or the like although no limitation is imposed in this respect.

During the hybridization of the nucleic acid target with the probes, stringent conditions may be utilized, advantageously along with other stringency affecting conditions, to aid in the hybridization. Detection by differential disruption is particularly advantageous to reduce or eliminate slippage hybridization among probes and target, and to promote more effective hybridization. In yet another aspect, stringency conditions may be varied during the hybridization complex stability determination so as to more accurately or quickly determine whether a SNP is present in the target sequence.

A SNP-specific probe can also be used in the detection of the SNP in amplified specific nucleic acid sequences of the target gene FAM129B, such as the amplified PCR products generated using the primers described above. In certain embodiments, these SNP-specific probes consist of oligonucleotide fragments. Advantageously, the fragments are of sufficient length to provide specific hybridization to the nucleic acid sample. The use of a hybridization probe of between 10 and 50 nucleotides in length allows the formation of a duplex molecule that is both stable and selective. Molecules having complementary sequences over stretches greater than 12 bases in length are generally advantageous, in order to increase stability and selectivity of the hybrid, and thereby improve the quality and degree of particular hybrid molecules obtained. One will generally prefer to design nucleic acid molecules having stretches of 16 to 24 nucleotides, or even longer where desired. A tag nucleotide region may be included, as at the 5′ end of the primer that may provide a site to which an oligonucleotide sequencing primer may hybridize to facilitate the sequencing of multiple PCR samples.

The probe sequence must span the particular nucleotide position that may be substituted in the particular SNP to be detected, here, position 17 of SEQ ID. NOs 1 and 2. Advantageously, two or more different “allele-specific probes” may be used for analysis of a SNP, a first allele-specific probe for detection of one allele, and a second allele-specific probe for the detection of the alternative allele. For example, one probe could be used for detection of the adenosine at position 17 of SEQ ID NO. 1 and another probe could be used for detection of cytosine at position 17 of SEQ ID NO. 2.

It will be understood that this invention is not limited to the particular primers and probes disclosed herein and is intended to encompass at least nucleic acid sequences that are hybridizable to the nucleotide sequence disclosed herein, the complement or a fragment thereof, or are functional sequence analogs of these sequences. Homologs (i.e., nucleic acids derived from other species) or other related sequences (e.g., paralogs) can be obtained under conditions of standard or stringent hybridization conditions with all or a portion of the particular sequence as a probe using methods well known in the art for nucleic acid hybridization and cloning.

Advantageously, probes may be affixed to substrates and used in “microarray” and other high-throughput detection applications such as those used in the Example below and which are well known in the art. Microarrays can show the presence of one or both SNP alleles, copy number (such as whether an individual is homozygotic, or heterozygotic for a particular polymorphism), and thus provide a genotype for an individual subject.

D. Subjects at Increased Risk of CA-MRSA

In one embodiment of the present invention, subjects with at least one or more copies of the allele corresponding to position 17 of SEQ ID. NO 1 are at increased risk of developing MRSA and/or CA-MRSA, or a recurrence of MRSA or CA-MRSA. In another embodiment of the present invention, subjects with at least one or more copies of the allele corresponding to position 17 of SEQ ID. NO 2 are not at increased risk of developing at developing MRSA and/or CA-MRSA, or a recurrence of MRSA or CA-MRSA.

Other SNPs, or other biomarkers, such as gene or protein biomarker, miRNA and the like, the levels or presence/absence of which are correlated with increased risk of developing MRSA or CA-MRSA, or the occurrence of recurrent MRSA or CA-MRSA may also be used alone or in conjunction with the SNP of the present invention to diagnose subjects who are at increased risk of developing MRSA and/or CA-MRSA, or a recurrence of MRSA or CA-MRSA. Other SNPs or biomarkers may identify a structurally or functionally abnormal FAM129B gene caused by a point mutation(s), a deletion, a truncation, or a translocation of at least a portion of the FAM129B gene. An exemplary biomarker may identify and/or detect the presence of (a) a decrease or an increase in expression of the FAM129B gene (as compared to a control group which is not at an increased risk of developing MRSA or CA-MRSA, or recurrent MRSA or CA-MRSA) or (b) the abnormal methylation of at least a part of the FAM129B gene. In one embodiment, methods to detect a structurally or functionally abnormal FAM129B gene may include using an oligonucleotide primer that is complementary to or identical to a portion of SEQ ID NO: 3 to amplify an oligonucleotide sample from a subject (and the amplified oligonucleotides may then be sequenced); or hybridizing oligonucleotides in a sample from a subject to an oligonucleotide probe having a sequence that is complementary to or identical to a portion of SEQ ID NO: 3.

Treatment of Patients at Increased Risk of Recurrent CA-MRSA

In some aspects of the method, subjects found to be at increased risk of developing MRSA, HA-MRSA or CA-MRSA or having a recurrence of MRSA, HA-MRSA or CA-MRSA may be treated with an antibiotic effective against MRSA. In other aspects, subjects found to be at increased risk of developing MRSA or having a recurrence of MRSA can be treated with appropriate topical and/or nasal treatments to remove surface colonies of or prevent colonization by skin-surface or intranasal populations of MRSA. Appropriate treatments may be increased sanitation (more frequent hand washing with regular or antibiotic soaps such as Hibiclens (4% clorhexidine), topical antibiotic treatments, and oral antibiotics, mouth rinses and nasal ointments containing antibiotics. See, e.g., Buehlmann, M. et al. “Highly effective regimen for decolonization of methicillin-resistant Staphylococcus aureus carriers” Infect. Control. Hosp. Epidemiol. (2008) 29(8); 510-6.

A more aggressive treatment of a MRSA, HA-MRSA or CA-MRSA patient may involve the administration of an antibiotic regime including the repeated and/or prophylactic use of one or more anti-MRSA antibiotics such as Vancomycin, Daptomycin, Linezolid, Ceftaroline, Telavancin, Bactrim and the like. Treatment of MRSA patients often includes decolonization efforts, frequent monitoring, long term follow-up and special treatment for any further surgeries (e.g. surgical prescreening for MRSA and antibiotic treatment for prophylaxis) including long duration evaluation and monitoring for infection. Treatment for patents at low risk of MRSA infection could involve as little as incision and drainage followed by administration of a common antibiotic or in some cases with no antibiotic at all.

Kits comprising the methods and devices of the MRSA risk assessment described here in are also described and would be known to one skilled in the art given the descriptions provided.

Some embodiments of the present invention may comprise a kit for determining whether a subject is at increased risk of developing MRSA, or a recurrence of MRSA comprising at least one primer for amplification of one or more nucleotides that occur at a loci corresponding to position 17 of comparison SEQ ID. NOS. 1, 2 or a combination thereof from a biological sample from the subject.

Other embodiments of the present invention may comprise a kit for determining whether a subject is at increased risk of developing MRSA or CA-MRSA, or a recurrence of MRSA and/or CA-MRSA, comprising at least one probe for detection of one or more nucleotides that occur at a loci corresponding to position 17 of comparison SEQ ID. NOS. 1, 2 or a combination thereof from a biological sample from the subject.

Some embodiments of the invention may comprise one or more probes for use in determining whether a subject is at increased risk of developing MRSA or CA-MRSA, or a recurrence of MRSA or CA-MRSA, wherein the one or more probes comprise the oligonucleotide(s) described by SEQ ID NOs. 1 and/or 2. Other embodiments of the invention may comprise an amplification product for use in determining whether a subject is at increased risk of developing MRSA or CA-MRSA, or a recurrence of MRSA or CA-MRSA, wherein the amplification product comprises an oligonucleotide sequence comprising SEQ ID NO. 1 and/or 2. Other embodiments of the invention may comprise amplification primers for use in determining whether a subject is at increased risk of developing MRSA or CA-MRSA, or a recurrence of MRSA or CA-MRSA, wherein the amplification primers comprise oligonucleotide sequences in SEQ ID NO:3 immediately flanking the location of SEQ ID NO:1 and 2; comprise SEQ ID NO:1 or 2 and oligonucleotide sequences in SEQ ID NO:3 immediately flanking the location of SEQ ID NO:1 and 2; or comprise SEQ ID NO:1 or 2.

The invention will now be further described by way of the following non-limiting examples.

EXAMPLES Example 1 Study Design

Fourteen participants were contacted and consented to collection of blood samples for analysis. Collection and analysis were approved through the Beaumont Institutional Review Board. Eleven participants were patients who were seen for recurrent community acquired MRSA skin infections (CA-MRSA) but had no known specific risk factors for developing recurrent infection. Three participants were controls and were cohabiting spouses of three of the patients. This gave controls who were directly and closely exposed to the patient (i.e., shared a bed) and were thus within the same environment but did not become infected with CA-MRSA.

Example 2 Methods

Collection and analysis was done via the Beaumont BioBank. Analysis was performed in an automated and blinded manner. Genomic DNA from all participants was prepared for analysis using Affymetrix Genome-wide Human SNP 6.0 microarrays. Each array contains more than 946,000 probes for detection of copy number variation and more than 906,000 single nucleotide polymorphism (SNP) probes for genotyping. One array per patient sample was prepared according to the manufacturer's protocol and scanned with an Affymetrix GeneChip® Scanner 3000. Affymetrix Genotyping Consol software and the Partek Genomics Suite were used for analysis and visualization of the data.

Data was subjected to per SNP and per sample quality control to minimize false positives. None of the remaining samples from individuals were excluded based on the expression data. SNPs from X and Y chromosomes were excluded from further analysis. SNPs with no call rates <5% and minor alleles frequencies >5% were included for further analysis. The final number of SNPs included in the analysis was 633,268.

A chi-square test was used to set the phenotype to be tested for association with the SNPs. Three models were tested:

-   -   1. Allele: frequencies of alleles (A vs. A′) were compared         between CA-MRSA subjects and the control subjects     -   2. Genotype: frequencies of three possible genotypes (AA, AA′,         and A′A′) were compared between CA-MRSA subjects and the control         subjects     -   3. Dominant/Recessive: two combinations of genotypes are         compared between CA-MRSA subjects and the control         subjects—Dominant (AA+AA′ vs. A′A′, with A as the causal         variant) and Recessive (AA vs. AA′+A′A′, with A as the causal         variant)

Example 3 Results

The analysis using each model revealed several potential SNPs of interest, but the most significant (p value 1.21×10-7) was located within the open reading frame of a gene identified as FAM129B. This SNP (SNP_A 8307872, rs2249861) was present with two copies of a single form in all 11 MRSA patients and with two copies of another form in all three controls. There were no participants who were heterozygous (one copy of the gene in each form).

The particular SNP in gene FAM129B which segregated between the control and CA-MRSA populations was located in an intron sequence. The SNP has the following sequence in CA-MRSA subjects: GGGGGCAAGTTAGTCAACCTGTCTGAGTCTTAG [SEQ ID NO:1] with the SNP location at position 17 underlined. Control populations had the alternate allele: GGGGGCAAGTTAGTCACCCTGTCTGAGTCTTAG [SEQ ID NO. 2] at position 17. 

What is claimed is:
 1. A method of predicting or assessing the level of risk of a subject developing a Methicillin-resistant S. aureus (MRSA) infection comprising: obtaining a biological sample from the subject, wherein said biological sample includes at least one oligonucleotide occupying a locus corresponding to position 17 of SEQ ID. NO 1; detecting the identity of at least one oligonucleotide occupying the locus corresponding to position 17 of SEQ ID. NO 1; determining whether at least one oligonucleotide occupying the locus corresponding to position 17 of SEQ ID. NO 1 is an adenine or a cytosine; and predicting and assessing the level of risk of the subject developing a MRSA, wherein an adenine occupying the locus corresponding to position 17 of SEQ ID. NO 1 indicates that the subject has a high risk of developing a MRSA infection and a cytosine occupying the locus corresponding to position 17 of SEQ ID. NO 1, indicates that the subject has a low risk of developing a MRSA infection.
 2. The method of claim 1, wherein the detecting step further comprises hybridizing at least one oligonucleotide occupying a locus corresponding to position 17 of either SEQ ID. NO: 1, to an oligonucleotide probe comprising a sequence that is complementary or identical to SEQ ID NO. 1, under stringency conditions than can detect the presence of different alleles at position 17 of said oligonucleotide or hybridizing at least one oligonucleotide occupying a locus corresponding to position 17 of SEQ ID. NO: 2, to an oligonucleotide probe comprising a sequence that is complementary or identical to SEQ ID NO: 2, under stringency conditions that can detect the presence of different alleles at position 17 of said oligonucleotide.
 3. The method of claim 2, wherein the detecting step further comprises evaluating the hybridization of at least one oligonucleotide from the biological sample which corresponds to position 17 of SEQ ID. NO
 1. 4. The method of claim 3, wherein the detecting step further comprises sequencing the oligonucleotide from the biological sample.
 5. The method of claim 4, wherein the detecting step further comprises amplifying the oligonucleotide from the biological sample.
 6. The method of claim 5, wherein the amplifying step uses at least one oligonucleotide primer and at least one oligonucleotide from the biological sample occupying a locus corresponding to position 17 of SEQ. ID. NO.
 1. 7. The method of claim 6, wherein the oligonucleotide primer comprises DNA.
 8. The method of claim 1, wherein a treatment step is taken after it is determined whether the patient has a high or low risk of developing a MRSA or CA-MRSA infection.
 9. The method of claim 8, wherein after it is determined that the patient has a high risk of developing a MRSA infection, the patient is given anti MRSA antibiotics.
 10. The method of claim 8, wherein after it is determined that the patient has a high risk of developing a MRSA infection, the patient is given anti MRSA antibiotics and is given decolonization treatments.
 11. The method of claim 8, wherein after it is determined that the patient has a high risk of developing a MRSA infection, the patient is given more than one course of anti MRSA antibiotics, decolonization treatments and is put on high infection alert for any future surgeries.
 12. The method of claim 8, wherein after it is determined that the patient has a low risk of developing a MRSA infection, the patient is not given any antibiotics and is only treated with incision and drainage.
 13. The method of claim 12, wherein, after it is determined that the patient has a low risk of developing a MRSA infection, the patient is treated with incision and drainage and given a routine antibiotic treatment that does not include anti MRSA antibiotics.
 14. One or more primers or probes to be used to amplify or detect at least one or more nucleotides from a biological sample, which one or more nucleotides occupy a locus corresponding to position 17 of SEQ. ID. NO.
 1. 15. The one or more primers of claim 14 wherein said one or more primers spans the nucleotide positions about position 17 of SEQ. ID. NO.
 1. 16. The one or more primers of claim 15 that is from about 8 to about 44 nucleotides in length.
 17. The one or more primers of claim 16 that is from about 14 to about 50 nucleotides in length.
 18. The probes of claim 14 wherein said one or more probes span the nucleotide positions about position 17 of SEQ. ID. NO.
 1. 19. The probe of claim 18 selected from a probe having a different disruption energy for one allele as compared to another allele; two probes, wherein the first probe is a sensor probe and the second probe is an anchor probe; and a SNP-specific probe.
 20. The one or more primers or probes of claim 14 in a kit designed for use by a caregiver who seeks to predict or assess the level of risk of a subject developing Methicillin-resistant S. aureus (MRSA) infection comprising: obtaining a biological sample from the subject, wherein said biological sample includes at least one oligonucleotide occupying a locus corresponding to position 17 of SEQ ID. NO 1; detecting the identity of said at least one oligonucleotide occupying the locus corresponding to position 17 of SEQ ID. NO 1; determining whether said at least one oligonucleotide occupying the locus corresponding to position 17 of SEQ ID. NO 1 is an adenine or a cytosine; and predicting and assessing the level of risk of the subject developing a MRSA or CA-MRSA infection, wherein an adenine occupying the locus corresponding to position 17 of SEQ ID. NO 1 indicates that the subject has a high risk of developing a MRSA or CA-MRSA infection and a cytosine occupying the locus corresponding to position 17 of SEQ ID. NO 1 indicates that the subject has a low risk of developing a MRSA or CA-MRSA infection.
 21. A method of monitoring and preparing a patient for surgery, wherein said monitoring and preparing comprises: obtaining a biological sample from the patient, wherein said biological sample includes at least one oligonucleotide occupying a locus corresponding to position 17 of SEQ ID. NO 1; detecting the identity of said at least one oligonucleotide occupying the locus corresponding to position 17 of SEQ ID. NO 1; determining whether said at least one oligonucleotide occupying the locus corresponding to position 17 of SEQ ID. NO 1 is an adenine or a cytosine; predicting and assessing the level of risk of the patient developing a MRSA infection, wherein an adenine occupying the locus corresponding to position 17 of SEQ ID. NO 1 indicates that the patient has a high risk of developing a MRSA infection and a cytosine occupying the locus corresponding to position 17 of SEQ ID. NO 1 indicates that the patient has a low risk of developing a MRSA infection; and wherein the predication and assessment indicates that the patient is at high risk for a MRSA infection, taking appropriate steps and care as one normally skilled in the art would take when operating on a person at high risk of developing a MRSA infection. 